1. Field of the Invention
The present invention generally relates to medical and hospital information systems. More specifically, it relates to computer systems and methods for use by doctors in treating patients.
2. Description of the Related Art
There has been an increasing need to reduce medical errors in hospitals and clinics. Responding to public concern over such errors, and seeking to standardize care around best practices to control quality and cost, American hospitals are purchasing costly clinical information systems installed with a technology known as Computerized Physician Order Entry (CPOE). Current estimates are that 10% of US hospitals have CPOE systems and the number is expected to grow to 20-30% in the next few years.
However, CPOE systems require a certain type of structured data to operate successfully. Manual entry of this data in the required format has proven very impracticable for busy healthcare professionals (hereinafter “physicians”) in the front-lines. Thus, the success of these systems has relied heavily upon pre-built templates referred to as order sets, a term known in the field of medical/hospital software development. Order sets, described in greater detail below, essentially offer templates of care for the most common diagnoses and procedures. Utilizing a checklist approach, they allow physicians to rapidly select the appropriate options for care in a structured data format. Order sets are critical to successful implementation of CPOE systems, and companies (ZYNX of Santa Monica, Calif., Healthgate of Burlington, Mass.) are in the business of supplying content for CPOE order sets.
Current order sets are generally designed for single diagnoses and organized in a rigid fashion. For example, a hospital may have separate order sets for “Community Acquired Pneumonia Admission”, “Appendectomy Postop” and “Congestive Heart Failure Admission”. However, an aging population and increasing success in managing chronic conditions over the long-term is resulting in a patient population that presents to hospitals with multiple comorbidities. For example, a patient may present with an acute pneumonia, but that pneumonia is superimposed upon chronic diabetes, peripheral vascular disease and emphysema. Furthermore, critically ill patients often require physicians to design a treatment plan by physiological system (cardiovascular, neurological) rather than by diagnosis to ensure that critical interrelationships aren't missed. For these complex patients, physicians often plan diagnosis and treatment using an internal mental model based around solving for multiple medical problems/conditions or around physiological systems, thereby creating a serious mismatch with conventional order sets which are designed for a single diagnosis in a traditional functional framework. Thus, the current state of the art forces physicians to develop treatment plans using a checklist around a single diagnosis. In contrast, there is a strong need by physicians for systems (CPOEs, order sets, etc.) that are better able to map to these different internal mental models for managing complex patients.